At retail clinics, health care is on sale

Marcus Pickett

Retail clinics offer basic health care provided by nurse practitioners and physician assistants at many retail pharmacy and drugstore chains. Target, Walmart, CVS and Walgreens are a few of the major national chains that have opened clinics in their stores over the past several years.

Such clinics usually don't require appointments and are open after traditional work hours and on weekends. So, although the services are limited, these clinics offer a more convenient (and often less expensive) alternative to traditional doctor visits.

What kinds of services do retail clinics offer?

Retail clinics do not provide emergency care. They do, however, provide a variety of treatments and screenings, including:

Coverage varies by health insurance provider. CIGNA, for example, charges the same co-payments it charges for regular doctor visits.

The affordability of retail clinics (compared with emergency rooms) has led some leading insurers to encourage their customers to take advantage of the clinics whenever possible. An Aetna brochure promotes the convenience and affordability of the clinics, stating that its customers are covered and simply need to present their Aetna ID cards.

Walgreens, meanwhile, has national agreements with UnitedHealthcare and CIGNA that allow it to directly bill flu shots to them. Blue Cross and Blue Shield of Minnesota has teamed up with MinuteClinic, according to America's Health Insurance Plans (AHIP).

What do the experts think?

Since they started becoming popular several years ago, retail clinics have been praised and questioned.

October 2007: AHIP declares the retail health clinic a "revolution in convenience" in an article that concludes that the "new health care concept" appears to be working. The popularity and presence of the clinics are expanding, and the clinics have generated high satisfaction rates, according to a Harris Interactive survey cited in the article.

August 2008: The Deloitte Center for Health Solutions, in its "Retail Clinics: Facts, Trends and Implications" report, concludes that retail clinics "are not a fad" but are "a trend being driven by consumers who seek more value from the health system."

March 2009: Near the height of the recession, medical blogger Dr. Kevin Pho writes in a blog entry that "the retail clinic era is over." Pho cites CVS closing 90 of its 550 MinuteClinic locations as well as the difficulty in turning a profit solely from office visits as reasons for the clinics' decline.

Moreover, Pho argues, as relative newcomers to the health care industry, retail clinics are not aware of how much liability and risk they may be assuming. As a result, he writes, a malpractice lawsuit is "inevitable."

May 2010: American Medical News publishes an article suggesting that although retail clinics largely "failed to live up to their initial hype," health care reform could bring a new wave of patients when the health insurance mandate goes into effect and more Americans get coverage. Thirty million more Americans will have health care coverage by 2019, according to Kaiser Permanente, leaving primary care doctors overwhelmed.

Deloitte's 2009 update to its 2008 report echoes this notion. The increased focus on preventive care inspired by health reform, according to the report, could lead to increased demand for and investment in retail clinics, which provide affordable screenings.